Satisfaction with treatment decision-making and treatment regret among Latinas and non-Latina whites with DCIS

Mónica E López, Celia P Kaplan, Anna M Nápoles, E Shelley Hwang, Jennifer C Livaudais, Leah S Karliner
Patient Education and Counseling 2014, 94 (1): 83-9

OBJECTIVE: To examine differences in treatment decision-making participation, satisfaction, and regret among Latinas and non-Latina whites with DCIS.

METHODS: Survey of Latina and non-Latina white women diagnosed with DCIS. We assessed women's preferences for involvement in decision-making, primary treatment decision maker, and participatory decision-making. We examined primary outcomes of satisfaction with treatment decision-making and treatment regret by ethnic-language group.

RESULTS: Among 745 participants (349 Latinas, 396 white) Spanish-speaking Latinas (SSL) had the highest mean preference for involvement in decision-making score and the lowest mean participatory decision-making score and were more likely to defer their final treatment decision to their physicians than English-speaking Latinas or whites (26%, 13%, 18%, p<0.05). SSLs reported lower satisfaction with treatment decision-making (OR 0.4; CI 95%, 0.2-0.8) and expressed more regret than whites (OR 6.2; CI 95%, 3.0-12.4). More participatory decision-making increased the odds of satisfaction (OR 1.5; CI 95%, 1.3-1.8) and decreased the odds of treatment regret (OR 0.8; CI 95%, 0.7-1.0), independent of ethnicity-language.

CONCLUSION: Language barriers impede the establishment of decision-making partnerships between Latinas and their physicians, and result in less satisfaction with the decision-making process and more treatment regret.

PRACTICE IMPLICATIONS: Use of professional interpreters may address communication-related disparities for these women.

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